Advice regarding helping our son adopt better sleep, nutrition, and academic habits...

Mark,

You may not be able to offer any specific advice on our issue, but I have to bring this up – we are at our rope’s end.

Our son, R___, is having a tough time focusing on his academics. He is 16, a junior in public high school, Port Orange Florida. He is in the IB (International Baccalaureate) program. Over the past year and a half his grades have steadily decreased: his current reporting period (4 week) GPA is 1.7 a solid “D.” He is an avid an accomplished soccer player, but at the rate he’s going he will be on academic suspension. His outlook for college is at best, not good – despite the fact that he definitely seems to want to go to college. (We are beginning to wonder if the IB program is just too hard for him, although says he really wants to do it.)

We’ve just subscribed to OPS. We’ve read your online material, in particular advice to one parent regarding a similar situation in which you made the following points:

(1) Let him do his own work – that’s his job, his teachers are his bosses.
(2) His sleep habits are poor – he stays up late – often past midnight, as late as 1:00. Wakeup is a chore taking 3-5 attempts.

Adding to this is the following:

(3) He has very poor nutrition habits. My wife has tried may times to prepare healthy meals – he will have no part of them, but drinks energy drinks, eats bagels and cream cheese, pizza, an occasional ham and cheese sandwich, never vegetables.

(4) He is hearing impaired – his acuity in the higher frequencies is significantly impaired. He has aids, but refuses to wear them (we suspect it may be a question of vanity, and refusal to acknowledge the impairment).

We have tried urging him to do his homework. That has not worked. Recently we have tried incentivizing him with money for good performance – his grades have just gotten worse (down to the current GPA).

My wife tends to have an authoritarian parenting style; I tend to have an indulgent style – so there is polarization in our approach – which may be making things worse.

Based on what I’ve just read (your advice to a parent in a similar situation minus the hearing and nutrition problems) we will likely follow your advice, and

(1) Remove the TV from his room
(2) Do the one reveille call in the morning – perhaps even with a real bugle.

We are also considering restricting his social life (going out on weekends, but no weekend sleepovers), but we would like your opinion.

Bottom line: If you have ANY specific advice regarding helping our son adopt better sleep, nutrition, and academic habits, we would SINCERELY appreciate it.

Many thanks in advance for any specific help,

Desperately yours,

H.

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Hi H.,

Re: sleep.

Many parents allow their children to stay up late on weekends to watch TV and play video games...

BIG mistake!

...then to make matters worse, they allow their children to sleep in on Sat. and Sun. mornings...

Another BIG mistake!

Why? Because it takes until the middle of the school week (i.e., approx. Wednesday) for the child to make up for sleep deficits (i.e., they get only about 4 -5 hours of sleep Sunday night since they have to get up on Monday morning for school...

...then the weekend comes, and the cycle starts all over.

Don't make these mistakes.

Also, he should only get one wake-up call. You are clearly taking the responsibility AWAY from him by nagging him to get up. As long as you nag -- he'll sleep.

Re: nutrition.

You have bigger fish to fry than this one. This should go in the "pick your battles carefully" file.

Re: academic habits.

I think you know where I stand on this issue since you've already read the recommendations.

Final point: I'm a bit concerned that you are rushing through the program. The academic biz is in Session #4 / Week #4 -- you just signed-up yesterday!

Rushing things WILL be the kiss of failure - I promise.

Mark

My Out-of-Control Son

Oppositional Defiant Disorder [ODD] in Adults

Dear Mark

I have just signed on for your e-course. My son has recently been diagnosed with ODD and thank God I have an answer to the challenge (understatment of the year!) that it has been trying to understand what was going on with him. He is only eight years old but I have had nightmares about what would become of his future and of my sanity!

The thing is the more I read about the disorder for my son, the more pieces fall in place for the troubles I have had and am still having with my husband and marriage. He is sooooo much like our boy in nearly every way. At the same time, all that I read on the subject pertains to children and teenagers. Although he would probably have a fit if he knew I was even thinking it about him, i desperately need to know if adults can suffer from the disorder as well?

Regards,

J.

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Hi J.,

Re: ...i desperately need to know if adults can suffer from the disorder as well?

Absolutely. And the good thing is: You can use many of the parenting strategies that you will be using with your son with your husband.

It is very common for a mother to feel as though she is raising two children -- her child and her husband. This topic leads to a discussion about co-dependency on the mother's part (which I don't have time to get into right now).

Maladaptive behaviors are serious enough when the adult cannot maintain employment or constantly moves from job to job, has trouble with "significant other" relationships (possible multiple divorces), or has a strong dependence on alcohol, substances or negative habits.

Although we're talking about adults here, young people can engage in similar behaviors when they have trouble in school, have difficulty making and keeping friends, and rely on fancy toys or video games to synthetically alter their mood.

Mark

My Out-of-Control Teen

Teachers Triggering Temper Tantrums in Students

Mark-

I’m a middle school teacher. Actually I purchased your ebook to help me understand – and cope with – some of my unruly students. It has been an immense help. One question: How do you deal with a student who – out of the clear blue – slips into a temper tantrum?

Thanks,

M.

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Hi M.,

When a youngster reportedly has 'temper tantrums' in school, one of the first questions I always ask is whether this is also happening in the home. If it is, then is it only happening when homework or school-related matters arise, or is it happening in other situations as well? Thinking about under what conditions the kid loses control can help us determine where to start looking, what accommodations might be needed, and what other assessments and/or interventions might be needed.

Suppose that the kid is not having 'temper tantrums' at home, but is having them in school. While it is still possible that it is the kid's disability that is the primary contributor the problem (e.g., a kid with depression may "explode" in school when asked to concentrate or produce for long periods of time), we also need to look closely at how the school is handling the kid. Have they made enough accommodations? If there's a plan in place, have they followed it?


==> My Out-of-Control Teen: Help for Parents

In my experience, it seems that in some cases, school personnel have been responsible for triggering a temper tantrum or pushing the kid past his or her limits. Consider the following (and unfortunately true) example where a teacher knows a kid has Oppositional Defiant Disorder and that one of the kid's symptoms is that he "has to" finish something he is reading. On a particular day, the teacher instructs the class to put their books down as it is time to do another activity. The kid with ODD doesn't comply, and the teacher cues him again to put the book down and start the next task. The kid with ODD continues reading and tries to leave the room to go finish the book. The teacher refuses, blocks the doorway, and tries to take the book away. The kid with ODD "explodes," and swings at the teacher.

In the preceding example, one could argue that we should hold the youngster responsible for his behavior and that he has to learn that no matter what, he cannot take a swing at people. And on some level, I'd agree with that. The problem with the school disciplining the kid for it, however, is that such consequences may not reduce the likelihood of it happening again if the youngster's compulsion is that severe, and it fails to discipline the teacher who failed to respect the youngster's limits. If teachers "get in the face" of youngsters who are known to have behavior problems, then aren't they as responsible for what happens as the youngster?

In my opinion, when it comes to school, the teachers, as the adults, have the responsibility to manage themselves so that they don't engage in an escalating pattern with the youngster. And one of the most effective ways to help school personnel recognize the limits and what to do in particular situations is staff development. Teachers are often concerned that they will lose their authority with the class if they don't "discipline" an out-of-control child. The reality is that their "discipline" is often punitive and escalates a bad situation into a full-blown "temper tantrum."

Even when teachers are not provoking or causing the youngster's problems, they may be the youngster's last hope of restoring themselves to a calmer state. Learning how to stay calm, recognize the signs of impending explosions, and helping the youngster make a graceful exit so that they can calm themselves are important skills. Realizing that you are not "rewarding the youngster for misbehavior" if you allow them to switch to an activity that is inherently interesting to them and that helps them focus and calm themselves is also important. Maintaining your empathy for an explosive kid can make all the difference.

 

==> My Out-of-Control Teen: Help for Parents

Son getting excitement from the meltdowns...

Thanks Mark. I'm really excited about this program, and just watching the videos I did yesterday and doing the quiz has made me realize it's going to help immensely. My teens aren't out of control yet, but one of them certainly is an intense child and displays many of the traits you speak about. The explanation of that type of child getting excitement from the meltdowns is something I've thought for a long time but didn't know how to put in perspective. I am looking forward to this program and have already learned and implemented some of your ideas.

D.

Online Parent Support

Risperdol and the treatment of ODD...

Hello Mark, What do you know about Risperdol and the treatment of ODD?

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In choosing drugs for ODD, look for drugs that have been proven safe in children, have no long term side effects, and have been found in research studies to be effective in extremely aggressive children and adolescents or in Comorbid conditions which children with CD often have. Each drug has certain problems that need to be watched for. The current medical literature suggests three basic principles when using psychiatric drugs in children:

1. Start low

2. Go slow, and

3. Monitor carefully

Start low means that you do not start any of these drugs at the usual dose, or the maximum dose. When you have pneumonia, it can be a real emergency. You want to give people plenty of medicine right away, and if there are problems, then you reduce it. Unfortunately, many people use this same strategy in the medical treatment of ODD. The problem is that big doses can cause big problems, and when the problems affect your mind and personality, this usually means trouble for the person taking the medicines. So start with the lowest dose possible. For example, if you use a drug called Clonidine, for a boy about 60 lb., know that the dose that will probably work for most boys that size is two pills a day. If you gave him that to start out with, you might win and it would work. But if he happens to be sensitive to that drug, he could have big problems. Although they would be reversible problems, it would probably make most children and adolescents and or parents never want to take the drug again. So what do you do? Start with a half of a pill a day, about 25% of the usual dose. That way if the child is sensitive to the drug, it causes little problems. Many children respond to drugs at very low doses, far below the usual recommendations.

Re: go slow. ODD is not an acute illness. Less than 10% of the people I see with this need to be treated very quickly. Most people whom I see with this problem have had it for years. As a result, there is no need to increase the dose quickly. By going slowly, it is a lot easier to manage any side effects because things don't happen suddenly. Also, it is easier to find the lowest effective dose.

Re: monitor. For each of the medical treatments for ODD, there are specific side effects, which need to be checked regularly. Some common ones are monitoring weight so that people are gaining weight, watch for tics, watch for depression, checking blood pressure and pulse, checking blood tests and EKGs, and making sure parents know what the side effects are of the different medications. In this way, if there is a problem, you can pick it up early and avoid the horror stories, some of which are true, about the medical treatment of this problem.

The following are drugs which have been tested in adults and children who are violent and aggressive for a variety of reasons – from ADHD to brain damage, to Conduct Disorder, and of course ODD:

Atypical Antipsychotics—These drugs were first used for schizophrenia, and that is how they got this name. They are now commonly used for many conditions where people are not psychotic. As you can see, these are not benign medications. All of them can have serious side effects. As a result, they are not used for small problems.

Risperidone (Risperidal)—This drug was initially developed to be a safer drug for adult schizophrenia. It was then found to be effective in children with schizophrenia and other psychoses. Then it was found to be helpful in some children with Tic disorders. Based on those findings it has been used in Conduct Disorder and aggression. These studies are probably the most exciting news for the medical treatment of CD in 20 years. Risperidone is called Risperidal and comes in a variety of sizes; .25mg, .5 mg, 1mg, 2mg and liquid. It also helps Tourettes and psychosis. Usually this is given twice a day. This drug usually shows an effect within hours of a dose. There are more studies done on this drug than all the other atypical antipsychotics combined.

Olanzapine (Zyprexa)—This drug was recently approved for mania in adults. It has been studied less in children. However the early reports are positive. The usual dose is about 5-15 mg a day. It comes in 2.5 mg, 5mg and 10 mg. It is also called Zyprexa. It is more expensive than Risperidone and in adults is associated with more weight gain. This can be given once a day.

Quetiapine (Seroquel)—This drug is a little different than the above drugs as it seems to cause very little problems with things like tremor and stiffness. In adolescents it can lower the blood pressure so the dose has to be increased slower. The dosage range is 200-800 mg a day. There are only a few articles on its use in children and adolescents, but these have been quite positive for mood disorders. I do not know of any study on using in CD. It comes in a 25mg and 100 mg size and has to be given twice a day. It is called Seroquel.

Mark Hutten, M.A.

JOIN Online Parent Support

He wants to take 2 days off of school next week to go hunting...

Hi,

I have been applying your techniques for about 5 weeks now and can say that things have definitely gotten better. We have had a couple moments but otherwise have been much happier and getting along great. I have read the emails regarding the poor grades and how I should let my son (14 yrs) take ownership of his grades and treat school like it's his job. I completely understand that and agree that the concept should work. I've been fighting with him for 4 years and gotten nowhere so it's obvious that I can't control the outcome. He thinks he can never do good enough for me. So I have told him that it is his job now and his future and he is in charge of it. He only has to live up to his own expectations.

Here's my question...he wants to take 2 days off of school next week to go hunting, a once a year opportunity. He says he will take care of making up all of the work that he will miss for those days ahead of time. I don't know if I should have a say in this or not if I am giving him the control. He has assignments that he missed and can't make up so I don't feel he should be taking time off. But since I've just given him the control and ownership should I let him prove to himself that he can take care of it and that I trust him to do it? The past assignments were missed while I was trying to be in control. Are these two separate things? Where do I draw the line and do I ever step in? Or do I completely give him the control? I understand missing school is not something that is acceptable but there are times when I can see exceptions. If he were pulling all A's and B's I wouldn't have a problem with it at all. I am just really confused about turning the ownership over at this point and where that leaves me with this decision.

Please help.

C.

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Hi C.,

This is a great question. Fortunately, the answer is an easy one.

"Schooling" takes place on multiple stages -- not just in the classroom. So this hunting trip will be much more of a learning experience for him than sitting in class. This is a wonderful opportunity to take education to a new, exciting level.

Let him go ...forget about the make-up work (that's his job).

Mark

P.S. As a former teacher, I would want him to go on the trip. And I would have him take pictures so he could give a report to the class regarding the trip.

Online Parent Support

Teens & Salvia: The New Drug of Choice

Hi Mark,

Things have been going better over this way with our 15 year old daughter. We've taken your advice and are trying to refine the techniques. Thanks for your previous help.

I do have a question and wondered if you had any insight. My daughter left a note from her boyfriend that she received at school laying by the computer last night. I found it this morning. He was talking about them experimenting with something called salvia.

I've been doing some research on this and it seems it is legal here in Indiana. I've discovered it is a hallucenogenic herb. Scary stuff.

From this note and the exchange of IMs I read this morning before I left for work, she seems to be struggling with this and does not want to do it. He stated he was going to try it and it was okay if she didn't.

A couple of days ago she asked about spending some time with this boyfriend and we did the "yes, but..." She fulfilled the but and now has our permission to spend time with him tonight. She is going to a friend's home after school today so I won't see her until she gets in tonight at her curfew.

Know anything about this salvia and its use with teenagers these days? What do you advise I do here?

Thanks,

G.

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Salvia divinorum, a green, leafy plant native to the Mazateca region of Mexico, provides its users with a short but intense hallucinogenic experience. A member of the mint family, it is not among the ornamental garden plants sold under the name Salvia at local nurseries.

The high is unlike that from LSD or psychedelic mushrooms, users say, nor is it anything like the experience of smoking marijuana. Salvia is not currently controlled by federal law, but dozens of states have moved to outlaw cultivation and sale of the plant, which is currently freely available for purchase on the Internet.

As an herb with psychedelic properties, Salvia divinorum is of pharmaceutical interest because of its uncommon affinity for opium/endorphin receptors—specifically the kappa opioid receptor. Most drugs with classical “psychotomimetic” properties, like LSD and MDMA, are highly selective for the 5-HT(2A) serotonin receptor.

Salvia is not one of these. Like ibogaine, another hallucinogenic shrub with a weak affinity for kappa opiate receptors, Salvia’s active ingredient--Salvinorin A--causes psychoactive effects not usually associated with stimulation of the brain’s internal opioid system. Previous research had identified a few such compounds, such as enadoline, which produced similar hallucinogenic effects.

The pharmaceutical industry has already taken a look at the kappa-opioid agonists in the ongoing search for new painkillers, and has so far discovered the usual psychedelic trap of too many unpredictable side effects for a commercial medication.

Classified as an “atypical” psychedelic, the salvia high is intense, dream-like, and short-lived, tapering off after about 30 minutes. An ounce of salvia in leaf form sells for as little as $40, but more concentrated liquid extracts sell for as much as $60 per gram.

Salvia’s addictive potential is low to nonexistent. No hallucinogen such as LSD or peyote has ever been found to be addictive in the classical sense.

Nonetheless, fearing that the inexpensive plant might become “the next marijuana,” as an Associated Press report put it last month, 24 states have passed, or are considering, legislation to restrict access to salvia. Elsewhere, sale of the drug has been restricted in Spain, Italy, Sweden, Belgium, Australia, and other countries. In the AP article, a Florida state legislator alleged—with unintended irony: “As soon as we make one drug illegal, kids start looking around for other drugs they can buy legally. This is just the next one.”

There are many reasons why Salvia divinorum is not likely to be “the next one.” According to drug expert Rick Doblin of the Multidisciplinary Association for Psychedelic Studies (MAPS), salvia “tastes terrible” and is “not going to be extremely popular.” The popular drug information site EROWID describes salvia as “more scary than fun” for many users, concluding that, whether smoked or swallowed, the plant is “aversive for many who try it.” Like ibogaine, salvia is no party drug. It can result in confusion, dizziness, depersonalization, and all the other hallmarks of a “bad trip.”

A related question is the extent to which kappa opioid receptor boosters might reduce the craving for addictive drugs. Ibogaine has been touted for having precisely this effect on heroin addicts and others. However, an early study of kappa opioid receptor-active compounds did not find any reduction in self-administration of cocaine.

The National Institute of Drug Abuse (NIDA) is studying salvia. The Drug Enforcement Administration (DEA), citing salvia as a “drug of concern,” is evaluating it.

My Out-of-Control Teen